This issue on redesigning ambulatory care provides a first for me. Although I am always learning, Frank Zilm and his coauthors provide us with an excellent introduction to simulation modeling-a field of which I knew virtually nothing. My only comment, other than to encourage those of you who are unfamiliar with the topic and beginning your learning process with this article, is that case mix measurement (for example, ambulatory patient groups or APGs) represents a useful tool for enhanced modeling precision.

The are many ways to reorganize an ambulatory care setting. Douglas Roblin and his colleagues provide us with the results of work redesign that Kaiser Permanente has undertaken in various regions throughout the country. Jim Schlosser provides us with a commentary from the perspective of the Veterans Administration and the Institute of Health Improvement headed by Don Berwick. Jeffrey Stoddard and his colleagues provide an important work that well illustrates financial incentives in ambulatory care. As you probably know by now, my perspective on this issue is: money makes the world go around.

Lea Nolan and colleagues continue an important conversation with their article documenting the challenges of enrollment of children in the State Child Health Insurance Program within community health centers.

I think we would all agree that maximizing patient safety in the ambulatory care setting represents a laudable objective. Terry Hammons and his colleagues review this literature as part of a conference that the Medical Group Management Association undertook for the Agency for Health Care Quality.

Involvement in ambulatory care research needs to start with the patient. Giovanni Apolone and his colleagues provide us with a European consumer perspective on clinical research in an outpatient setting. Kevin Shulman comments on this important issue from an American perspective.

Physicians for Human Rights and Mark Holt conclude this issue with their regular contributions on, respectively, human rights and Dr. Holt's jaundiced view of health care from the Republic of Texas.